Delivering Biomedical Information Services In FY16, NLM greatly expanded the quantity and range of high quality information available to researchers, health professionals, and the public. Among the NLM's intramural programs that contribute to its national biomedical information services are: PubMed: PubMed, which incorporates MEDLINE, is NLM's premier bibliographic database with over 26 million references to biomedical journal articles. MEDLINE articles are indexed by experts using the Medical Subject Headings (MeSH) controlled vocabulary, updated annually. In FY16 over 800,000 new indexed citations were added. PubMed Commons, which enables authors to share opinions and other information about scientific publications, potentially helping to improve reproducibility, added comments on nearly 1,500 PubMed articles. NLM also expanded use of automated indexing technology to increase efficiency. PubMed Central (PMC): The PMC archive of 4 million fulltext journal articles is central to the effort to make published results of NIH-supported research publicly accessible. As of FY16, PMC also enables public access to published results of research supported by 7 other federal agencies, as well as private and international research funders. MedlinePlus and MedlinePlus en espanol: These consumer health information resources cover over 985 topics, with selected materials in more than 40 languages. MedlinePlus Connect links electronic health records to patient education information from MedlinePlus by leveraging standardized codes and vocabularies required for meaningful use. In FY16, MedlinePlus Facebook pages were added in English and Spanish. Clinical Trials: ClinicalTrials.gov covers over 225,000 clinical research studies in 192 countries, with hundreds added weekly. It also contains summary information about trial results, including adverse effects, in accordance with the FDA Amendments Act of 2007 (PL 110-85). In FY16, more than 24,000 new trials were registered. Summary results of more than 4,000 trials were added, bringing the total to over 22,500. NLM staff also assisted NIH in developing the final rule implementing clinical trials provisions of FDAAA and a new policy covering registration and results submission for all NIH-funded trials. Toxicology and Environmental Health: Toxicology Data Network (TOXNET) is a primary reference for toxicologists, poison control centers, public health officials, physicians and environmental health professionals, and includes databases such as TOXLINE, Toxic Release Inventory, Hazardous Substances Data Bank, ToxMap and HaxMap. K-12 resources include an environmental health website and the GeneEd resource to support genetics education. Drug Information Resources: Drug information resources include DailyMed and Pillbox. DailyMed provides medication content and labeling information from package inserts for nearly 90,000 marketed drugs; interface changes were made for improved mobile access. Pillbox enables rapid identification of unknown solid-dosage medications based on physical characteristics and high-resolution images. Both are linked to NLM's RxNorm standard drug names. In FY16, NLM hosted a Pill Image Recognition Challenge under the America COMPETES Act to create software to match unknown pills from smartphone photos against the NLM RxIMAGE database. Disaster Preparedness and Response: NLM's Disaster Information Management Research Center (DIMRC) provides access to disaster information, promotes use of libraries in disaster preparedness and response, and supports uninterrupted access to critical health information resources when disasters and public health emergencies occur, such as Zika in FY16. DIMRC produces WISER, CHEMM, and REMM, emergency responder tools for hazardous materials and chemical, biological, radiological, and nuclear incidents. Molecular Biology, Bioinformatics, and Human Genome Resources: NCBI resources include more than 40 integrated molecular biology databases and bioinformatics software tools such as GenBank, Entrez, BLAST, RefSeq, dbGAP, Genomes, PubChem, Genetic Testing Registry, and ClinVar. Continuing areas of emphasis included addressing the impact of enormous quantities of data from high throughput sequencing and microarrays; organizing phenotypic and genotypic data from genome-wide association studies; and enhancing interfaces to journal literature retrieval to facilitate search and discovery. With the CDC, FDA, and USDA, NCBI developed database and analytic tools to use high throughput sequencing to more rapidly and accurately identify pathogens causing food-borne illnesses; similar technology is being applied to develop resources for combating antimicrobial resistance. Outreach Promoting Public Awareness and Access: Consumer health websites and the NIH MedlinePlus Magazine, in English and Spanish, convey the latest useful research findings in lay language. NLM outreach programs, many of which are achieved through the National Network of Libraries of Medicine, enhance awareness of its information services, with emphasis on underserved populations. Dozens of community-based projects are funded each year. In FY16, the support mechanism for the Network's Regional Medical Libraries was changed from contracts to cooperative agreements. Health Services Research: NICHSR promotes access to public health and health services research information through such databases as: HSRProj, covering over 15,000 health services research projects from about 200 funding organizations; HSRR for research datasets, instruments and software relevant to health services research; and HSTAT, with high quality evidence reports, guidelines, technology assessments, consensus statements, and treatment protocols. Structured search queries are developed to aid in searching PubMed, ClinicalTrials.gov, and HSRProj for information on health services research, comparative effectiveness, population health, health disparities, and Healthy People 2020 objectives. Advanced Information Systems and Research Tools: LHNCBC and NCBI continued to conduct research in biomedical informatics and computational biology, tested informatics interventions, and developed new scientific computing tools. For example, researchers enhanced tools that support standards-based electronic health records; developed tools to detect tuberculosis in chest x-rays and count malaria parasitic cells in blood smears; developed open-source programming pipelines to convert CT data to 3-D printable models; improved methods for integrated search and discovery of biomedical images and text; and provided expertise for the trans-NIH BD2K initiative to make research data more broadly available and discoverable. Health Data Standards: As the HHS central coordinating body for clinical terminology standards, NLM provides essential tools for meaningful use of electronic health records (EHRs) and health system interoperability. NLM develops, supports, or licenses for free U.S.-wide use the key clinical terminologies (RxNorm, LOINC, SNOMED CT) designated as standards for U.S. health information exchange. The Unified Medical Language System Metathesaurus, with more than 13 million concept names from nearly 200 vocabularies, is a distribution mechanism for standard code sets and vocabularies used in health data systems. In FY16, NLM launched the NIH Common Data Elements Repository to facilitate data sharing and aggregation; provided CDE tooling for data element harmonization; published updated value sets to support CMS Clinical Quality Measures; launched the VSAC Collab site for author collaboration; updated vocabulary mappings useful in achieving meaningful use; and augmented AccessGUDID with over 500,000 implantable device records, in support of the 2018 requirement that certified EHR Technology exchange implantable device information.